Sustainability Seal Application

The Keep Nebraska Beautiful Sustainability Seal Program application lists various actions that businesses can take to work towards and achieve sustainability. This application is used for many diverse types of businesses in Nebraska. Some categories/actions either may not be applicable or your business may not have control to implement depending on if you are a property owner, management company, or tenant, however, all are invited to apply.

Scores will be tabulated based on the percentage of actions a business has taken compared to the total possible actions that apply for the business, so please continue to the end even if you feel you are unable to implement many of the actions listed.

This application should take approximately 15-20 minutes to complete.

"*" indicates required fields

Step 1 of 7

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General Business Information

Contact Information*

First Name Last Name

Phone*

Phone

Email*

Business Name

Business Address*

Street Address Address Line 2 City State ZIP Code

Business Mailing Address

Same Address As Above

Enter Mailing Address

Business Mailing Address*

Street Address Address Line 2 City State ZIP Code

Does your business own or lease your building?

Own

Lease

What type of business are you?*

Retail

Food

Industrial

Business Services

Other

Number of employees?*

Solid Waste Prevention

Complete the application by checking ONE of the three bubbles that corresponds to the action that you/your business are currently doing as follows:

YES, that action has been taken or policy is already in place
NO, that action has not yet been taken
N/A, that action does not apply to my business

Do you encourage reuse in the following areas?

Use/provide reusable products (e.g. coffee cups, filters, dishes, silverware, towels, boxes, bags, containers)*

Yes

N/A

Allow and encourage customers to bring in reusable container/cups/lids*

Yes

N/A

Reuse or repurpose items as alternatives to throwing away and buying new, including packaging and mailing materials?*

Yes

N/A

Do you reduce the following?

Paper waste by implementing electronic distribution, communications or file keeping programs*

Yes

N/A

Paper waste by reducing copying, printing bulk mail, and encourage two-sided printing*

Yes

N/A

Food waste by providing organics collection or participating in food rescue programs*

Yes

N/A

Building construction or renovation waste by selecting deconstruction over demolition*

Yes

N/A

Single-use carryout bags (paper, plastic, or other material including compostable or other) by asking customers if they need a bag, providing a discount for customers who bring their own bag, or charging a bag fee

Yes

N/A

Paper towel waste by installing motion sensor paper towel dispensers, air dryers or reusable towels near all sinks*

Yes

N/A

To-go waste by providing to-go utensils and condiments only per customer request*

Yes

N/A

To-go waste by providing straws only per customer request*

Yes

N/A

Plastic waste by not purchasing/offering single-use plastic bottles to customers or employees*

Yes

N/A

If you are a manufacturer, do you have a waste diversion program in place to reduce landfill waste?*

Yes

N/A

Recycling

Complete the application by checking ONE of the three bubbles that corresponds to the action that you/your business are currently doing as follows:

YES, that action has been taken or policy is already in place
NO, that action has not yet been taken
N/A, that action does not apply to my business

Do you provide the following services?

Trash and recycling bins at individual workstations or for customer use*

Yes

N/A

Co-located trash, recycling and organic (if applicable) bins*

Yes

N/A

Trash, recycling and organics (if applicable) collection and hauling*

Yes

N/A

Do you recycle the following?

Outdated/out of service electronics (e.g. computers, printers), light bulbs and batteries*

Yes

N/A

Paper, cardboard, glass, plastic and aluminum*

Yes

N/A

Plastic film, bags, pallet wrap*

Yes

N/A

Pallets, discarded wood materials and wood debris*

Yes

N/A

Toner and inkjet cartridges*

Yes

N/A

Used motor oil/oil filters*

Yes

N/A

Purchasing

Complete the application by checking ONE of the three bubbles that corresponds to the action that you/your business are currently doing as follows:

YES, that action has been taken or policy is already in place
NO, that action has not yet been taken
N/A, that action does not apply to my business

Do you purchase the following?

BPI certified compostable to-go food containers/cups:*

Note: Look for products that include the BPI logo.

Yes

N/A

Recyclable (non-black) to-go food containers/cups:**

*Note: Black plastic cannot not be properly sorted/recycled

Yes

N/A

Paper/compostable straws:*

Yes

N/A

Prioritize purchase of goods from sustainable companies:*

Yes

N/A

Sustainably made products:*

Yes

N/A

Recycled paper products:*

*e.g. copy paper, letterhead, business cards

Yes

N/A

Safer, eco-friendly janitorial supplies and maintenance products:*

Yes

N/A

Recyclable toner and inkjet cartridges:*

Yes

N/A

Products locally to limit/reduce transportation:*

Yes

N/A

Energy

Complete the application by checking ONE of the three bubbles that corresponds to the action that you/your business are currently doing as follows:

YES, that action has been taken or policy is already in place
NO, that action has not yet been taken
N/A, that action does not apply to my business

What actions have you taken to understand your business energy use

Perform energy audit/profile:*

*Energy Smart, Energy Star, or equal

Yes

N/A

Track energy usage in an energy audit:*

Yes

N/A

What actions have you taken to manage your business energy use?

Building qualifies for green building certification:*

*i.e. LEED or Energy Star

Yes

N/A

Implement/execute suggested actions from energy audit:

Yes

N/A

Set computers to energy saving mode each day:*

Yes

N/A

Utilize smart power strips and/or turn off all unused equipment to reduce plug loads in common areas:*

i.e. break room, storage room

Yes

N/A

Replace incandescent bulbs with energy efficient fluorescent or LED bulbs:*

Yes

N/A

Install programmable or “smart” thermostats:

Yes

N/A

Install/utilize motion sensors, timers, or other controls to limit energy use, where appropriate:

Yes

N/A

Utilize “Energy Star” equipment:

Yes

N/A

Turn off all lights at end of work day:

Yes

N/A

Turn off all lighted signs at end of work day:

Yes

N/A

Complete HVAC maintenance/tune-up on HVAC equipment on routine basis:

Yes

N/A

Employee and Customer Involvement Action

Complete the application by checking ONE of the three bubbles that corresponds to the action that you/your business are currently doing as follows:

YES, that action has been taken or policy is already in place
NO, that action has not yet been taken
N/A, that action does not apply to my business

How do you involve employees & customers in green business practices?

Involve employees by establishing a “green committee”:*

Yes

N/A

Provide training for employees on implementing green business practices:*

Yes

N/A

Institute resource reduction incentives, contests or rewards:*

Yes

N/A

Participate in local clean up event(s):*

e.g. park clean up, Adopt-A-Street, etc

Yes

N/A

Incentivize employees to explore/implement sustainable solutions:*

Yes

N/A

Encourage “green” practices by customers:**

e.g. bringing your own bag(s), offering incentives/discounts for customers who participate in trade-in/recycling programs.

Yes

N/A

Organize eco-friendly commuting initiatives, such as carpooling or biking-to-work programs, to reduce the environmental impact of employees' daily commute:*

Yes

N/A

Other

Complete the application by writing a short answer response or write N/A (that action does not apply to my business).

Have you received any certifications or awards related to sustainability or environmental stewardship?*

What did we miss that you want to share regarding your green business practices?*

Any final questions or comments?*

Will you commit to sharing/passing on this application or information about the program to another business in Nebraska? If yes, please specify the name of the business?*